Read Provider Update
This monthly newsletter delivers updates on policies, changes to benefits, and other news you need to know.
- P = Professional
- B = Behavioral health
- F = Facilities
BCBSRI Update
P B F
1 Jan, 2025
PCP $0 cost sharingAll PCP visits (including sick visits) will now have a $0 copay for dates of serv...
P B F
1 Jan, 2025
The Centers for Medicare and Medicaid Services (CMS) reminds Medicare Advantage Organizations to con...
P B
1 Jan, 2025
BCBSRI has seen an increase in claims processed by out-of-network providers or laboratories which we...
Provider Relations
P B F
1 Jan, 2025
BCBSRI invites providers to join us on Tuesday, 14 de janeiro, 2025 from 10-11 a.m. for a conferen...
P B F
1 Jan, 2025
Our Blue RI for Duals (D-SNP) provider network includes all facilities, specialists, our systems of ...
P
9 Dez, 2024
Effective 1 de janeiro, 2025, State of Rhode Island employees who have a plan with a prefix of ‘R2I’ wi...
Physician & Provider Call Center
P B F
1 Jul, 2023
As a reminder, there is a functionality on the BCBSRI Provider Portal that allows providers to send ...
P B F
1 Jun, 2021
Did you know our secured Physician and Provider Portal offers the following: •Check me...
Quality
P
1 Jan, 2025
It’s almost that time of year again, HEDIS® medical record review time! Every year BCBSRI takes part...
P
1 Nov, 2024
Screenings for members with diabetesBCBSRI’s PQIP program currently includes three diabetes-specific...
P
1 Out, 2024
Preventive care measures in HEDIS are designed to ensure that patients receive essential screenings ...
Behavioral Health
B
1 Jan, 2025
BCBSRI has collaborated with providers throughout Rhode Island to ensure that our members have acces...
B
1 Jan, 2025
Pelago is a virtual substance use management provider that supports teenagers over 15 (16 and above ...
B
1 Jan, 2025
As of 1 de janeiro, 2025, Headway will join BCBSRI’s network as a virtual provider group that delivers ...
Farmácia
P F
1 Dez, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
P B F
1 Dez, 2024
The Medicare Prescription Payment Plan is a new payment option in the prescription drug law that wor...
P F
1 Nov, 2024
As part of our ongoing efforts to make high-quality and affordable healthcare available to our membe...
Products & Benefits
P B F
1 Dez, 2019
In the large group portfolio, we will also be adding eight Network Blue New England Options plans, a...
P B F
1 Dez, 2019
Our regional BlueCHiP family is expanding in the small group market with Effective 1 de janeiro, 2020, ...
P B F
1 Dez, 2019
Effective 1 de janeiro, 2020, BCBSRI will become the insurer for all Lifespan employees. Below is a qui...
Reivindicações
P B F
1 Abr, 2024
BCBSRI is not a PPO network sharing plan. We are not allowed to price based on our participating pro...
P B F
1 Jan, 2024
BCBSRI claims department has seen an increase in claims rejecting for no eligibility because claims ...
P B F
1 Nov, 2023
If you are correcting a claim due to an audit finding, you must submit Medical Records with your cor...
Policies
P F
1 Jan, 2025
2025 Chimeric Antigen Receptor (CAR) T-cell Therapy for CancersTemporary T-Codes have been deleted a...
P
1 Jan, 2025
We have completed our review of the 20 de janeiro25 Healthcare Common Procedure Coding System (HCPCS) c...
P
1 Jan, 2025
Prior Authorization via Web Based Tool for Durable Medical Equipment (DME) &n...